DOCSLIB.ORG

The Changemakers of Health Care Delivery ANNUAL IMPACT REPORT 2019

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Changemakers of Health Care Delivery ANNUAL IMPACT REPORT 2019 The Changemakers of Health Care Delivery ANNUAL IMPACT REPORT 2019 Mission VillageReach transforms health care to reach everyone. Photo Credit: Henry Sempangi Sanyulye A Message from the President to You Almost twenty years ago, VillageReach was founded to make sure that vaccines reached every rural health center in northern Mozambique. From that original demonstration work, a movement was born. In 2019, in collaboration with partners across the globe, our solutions have improved access to health care for 43 million people across 10 countries in sub-Saharan Africa. Transforming health care delivery and systems for the most under-reached requires tremendous collaboration, collective action and partnerships. As I look back at 2019, one thing is clear - behind every success and every solution, there are changemakers. Changemakers champion transformative change in health care delivery in their communities. They work tirelessly every day to advocate for a world where each person has the health care needed to thrive. Today, we highlight some of the incredible milestones of 2019, and the changemakers who influenced them. • Malawi: The handover of Chipatala cha pa Foni – or Health Center by Phone – to the Ministry of Health and Population represents a major milestone for the commitment to Universal Health Coverage in Malawi. In this report, you will meet Patience Tchwonge, a changemaker whose contributions helped make this possible. • Mozambique: In Zambézia province, health centers would often run low on medicines and supplies. By partnering with the private sector, we made tremendous progress in supporting the government’s vision of a reliable, integrated supply chain that reaches every health center in 2019. In this report, you will meet Chaido Francisco Nomeado, a changemaker who is responsible for getting medical supplies regularly and safely to remote health centers. • The Democratic Republic of Congo (DRC): It was a historic moment for a rural health center in Equateur province when the community gathered in August 2019 to watch the first children receive vaccines delivered by drones. In hard-to-reach communities, drones can provide a reliable and cost-efficient way to ensure health workers have access to life-saving vaccines and essential medicines for their patients. In this report, we will introduce you to Emmanuel Bosala, the changemaker who was there for the first delivery and vaccinated the first ten families. In 2019, world leaders ratified a bold agenda for Universal Health Coverage. To reach these goals, we need to accelerate the pace of change. Gaps and inequities in health services are still leaving people behind, and targeted, cost-effective solutions are required to close these gaps. We know that this change – both big and small – will require changemakers. Changemakers like Patience, Emmanuel and Chaido motivate us every day and remind us that people make health systems strong. Together, we will meet the challenges ahead. Warm regards, Emily Bancroft, President A road in Equateur, Democratic Republic of Congo. Credit: Henry Sempangi Sanyulye 2 VillageReach Impact by the Numbers In 2019 43 million people benefited from increased access to quality health care 2,000 health centers across sub-Saharan Africa have improved availability of medicines 12,000 health workers have access to data systems that provide the information they need to make critical decisions 1,300 health workers have greater capacity to manage health commodities, expand the scope of their services and deliver quality care A sports utility vehicle traverses through grasses at the last mile. Credit: Denis Onyodi 3 Malawi A Health Center is Only One Call Away for Expecting Mothers Patience Tchongwe always knew she would be ready to answer the call when it came to public Patience Tchongwe looks at hotline service. When she joined Malawi’s Chipatala cha pa Foni (CCPF), or health center by phone in information with a staff member. Credit: Joseph Brown Chichewa, her desire to make a difference was realized. In 2015, Patience became a part of the hotline as a nurse midwife specializing in nutrition and food science. At that time, CCPF was only operating in two In 2019, the Chipatala cha pa districts with three volunteers behind the phones offering advice about Foni program expanded its maternal and child health. But even in its early stages, the Ministry of Health and Population (MoHP) and Patience’s team could see the value the hotline was reach ensuring nearly 7 million bringing to Malawians. Malawians had access to quality health information. “We were changing the lives of many people, and the Minister of Health saw that. He decided to hire more nurses with appropriate diplomas and qualifications,” Patience said. From then on, Patience would spend long hours and late nights developing the critical health information and the necessary tools for her hotline workers, so that they could properly inform callers and bring them the health care they deserved. Her hard work paid off. She became a key liaison between the MoHP and VillageReach as CCPF transformed into a nationwide offering with an average of 3,000 calls per month. “CCPF went from maternal health advice to covering questions about all health topics,” Patience said. Now standard health areas—including nutrition, water, sanitation and hygiene, infectious diseases, and sexual and reproduction health for young people—can be discussed with Malawians. But through the program’s expansion and success, Patience never forgot CCPF’s initial roots as a resource for mothers and their children’s health. As the senior hotline supervisor, she worked diligently to talk with expectant mothers and leave messages for them on what to expect during their pregnancy and how to practice proper prenatal care. She wanted, more than anything, for women to understand the value and life-saving capabilities of having their child in a health facility. 4 In 2018, Patience began offering advice to Ellena from Chibwana, who was expecting and had reached out to CCPF for their expertise. Like many women in her village, Ellena had her first two children at home, but with her third child on the way, she wanted to heed the advice of a community health worker and take advantage of the hotline. “We predicted her due date for her, so she would know when would be the best time to go to the health center for the baby’s delivery, which was important for her since the center was 14 kilometers away from where she lived,” Patience relayed. Thanks to the hotline, Ellena became the first woman to give birth in the Kwitanda Health Center rather than at home - a milestone for mothers in Ellena’s remote community. The CCPF team had also projected Ellena’s due date perfectly, with her daughter Eliza born just one day before the hotline’s estimation. Patience saw the health care progress she had dreamed of come to life. Women were gaining health care knowledge and utilizing its transformative power for themselves and their children. The impact of her work had reached new heights, and there was no going back, only forward. Several weeks after the birth of Eliza, Patience journeyed to Ellena’s village to visit the newborn child In 2018, Patience (far right) and her team offered Ellena (second from right) advice on what and ask Ellena if she would encourage others in her to expect during her third pregnancy and also predicted her due date, so she would know community to use CCPF. “She volunteered to be an when to make the 14-kilometer journey to the local health center. Credit: VillageReach advocate for CCPF,” Patience stated with enthusiasm. “We also kept sending her messages and she continued to go to the center for her baby’s wellness visits. Other mothers will be calling CCPF and coming to the center now to deliver their babies because of her story.” Incredible CCPF experiences like these are becoming the norm, and because of this, Patience was recognized for her dedication and meticulous work. In 2020, the State President of Malawi presented Patience and VillageReach Country Director Dr. Alinafe Kasiya with a prominent award recognizing CCPF as a Transformative Initiative for Malawi. The government of Malawi has complete confidence in CCPF’s power to bring health care information to its communities. Malawi’s MoHP completely took over operations for the health hotline. Twenty new hotline staff members received their first paycheck, which is demonstrative of the government’s commitment to CCPF. As she reflects back on the last five years, Patience said, “There’s nothing better than seeing CCPF give Malawians the ability to make informed decisions about their health and greater autonomy over their future.” “We’ve empowered Malawians like Ellena to take control of their health and imparted them with the knowledge they need, bringing about a great change in our public health care. Hospitals are even telling us how informed the CCPF people are and how they are asking for services.” Changemakers like Patience Tchongwe are transforming health care for everyone. 5 Mozambique A Change of Wheels to Get Medicines to Health Centers In Mozambique, getting medicines to provincial warehouses is only one step in the supply chain journey. From there, changemakers like Chaido Francisco Nomeado ensure those medicines get to remote health centers. Chaido is a dispatch clerk responsible for delivering medicines to six health centers in the hardest-to- reach district in Zambézia province, Chinde. His journey requires several days, a “change of wheels” for a six-hour sailboat ride across the Zambezi River and a lot of discomfort navigating rough A mother rests in front of a health center on the first roads and battling mosquitoes. But to him, being a dispatch clerk is day of a vaccine campaign. Credit: Denis Onyodi not just a job, it is a mission.
Load more

Recommended publications
  • Landscape Analysis of Electronic Immunization Registries; Lessons Learned from a Landscape Analysis of EIR Implementations in Low and Middle Income Countries
    Q1 2020 REPORT April 2020 SUBMITTED Landscape Analysis of APRIL 2020 Electronic Immunization Registries Lessons learned from a Landscape Analysis of EIR implementations in Low and Middle Income Countries LMSC QUARTERLY REPORT | Q3 2018 I www.villagereach.org // [email protected] Table of Contents EIR Landscape Analysis Acronyms ................................................................................. V Executive Summary .................................................................. 6 Background .............................................................................. 8 Methodology of Landscape Analysis ....................................... 9 . Methodology ...................................................................................... 10 Landscape Analysis Findings .................................................. 10 . Summary of Early EIRs Identified: Focused in Paho Region ............... 10 . Recent EIRs and Bid Initiative EIRs ..................................................... 11 Insights on Sustainability ....................................................... 11 Insights on Functional Requirements .................................... 13 . Additional Requirements to Consider ................................................ 15 Table 2: Additional Functional Requirements ..................................................................... 15 Table 3: Functional Requirements by EIR Goal .................................................................... 16 . Selecting an EIR System .....................................................................
    [Show full text]
  • Guidance and Preferences in Villagereach Communications
    Guidance and Preferences in VillageReach Communications September 17, 2019 These guidelines were created by the first External Communications Working Group, established by VillageReach Seattle’s Diversity & Inclusion Group (DIG). DIG was started in Fall 2016 after a discussion between staff member Jodi-Ann Burey and President Evan Simpson regarding concerns about the racial and cultural diversity among staff in the Seattle headquarters office and the post-colonial power dynamics of US-based organizations working in global health. Anna Shaw and Jodi-Ann Burey led the development of these guidelines, with support from other External Communications Working Group members Matt DeGooyer, Sandy Hawley, and Melissa West. CONTENTS Guiding Principles .................................................................................................................................. 2 English Language Guidance .................................................................................................................. 3 Terminology Guidance .......................................................................................................................... 5 Grammar Preferences ........................................................................................................................... 8 Before and After Language Examples ................................................................................................ 11 Communications Complaint Process.................................................................................................
    [Show full text]
  • Signature Ofofficv"
    Return of Organization Exempt From Income Tax OMS No. 1545·0047 Form 990 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung 2009 Oepartment of the T,easu<y benefit trust or private foundation) Open to Public Int...nal Revenue Service ~ The organization may have to use a copy of this return to satisfy state reporting requirements. Inspection A For the 2oo9 calendar year, or tax year beginning and ending B Check if C Name of organization 0 Employer identification number applicable: Please use IRS PROGRAM FOR APPROPRIATE TECHNOLOGY IN [!]Address label or change print or HEALTH (PATH) DName type. change Doing Business As PATH 91-1157127 D'nitial return See Number and street (or P.O. box if mail is not delivered to street address) ~~oom/suite E Telephone number DTermin- Specific ated Instruc- 2201 WESTLAKE AVENUE 00 206-285-3500 DAmended tions. return City or town, state or country, and ZIP + 4 G Gross receipts $ 324 896 ,743. DI\PPllca- tlon SEATTLE, WA 98121 H(a) Is this a group retum pending F Name and address of principal officer:CHRISTOPHER J. ELIAS for affiliates? DYes [!]No SAME AS C ABOVE H(b) Are all affiliates inciuded? DYes DNo I Tax·exempt status: l.1U 501 (c) ( 3 ).... (insert noJ L J 4947(a)(1) or L J 527 If "No," attach a list. (see instructions) J Website: ~ WWW.PATH.ORG H(c) Group exemption number ~ K Form of oraanization: Lx J Corporation L J Trust L J Association L J Other ~ I L Year of formation: 1981 I M State of legal domicile: WA I Part II Summary 1 Briefly describe the organization's mission or most significant activities: SEE PART III LINE 1 0 c:'" co a;c: 2 Check this box ~ D if the organization discontinued its operations or disposed of more than 25% of its net assets.
    [Show full text]
  • 2019 Annual Report
    Annual Report 2019 Innovating to improve the health of everyone, everywhere for routine immunization to 1 in 10 children born on Earth each year. Now, women-centered solutions to clean cooking. We see ourselves as mutual A Message that scope is expanding, as Covid vaccines will need to reach not just kids, participants and collaborators — with health workers, with governments, with but everyone. Our Vaccine Program team members are taking on new global women in remote areas preparing food for their families — as we build, iterate, leadership challenges to address the current crisis, and we are grateful to be and expand the systems-strengthening capacity of our tech. And we push our able to offer our experience and expertise to the monumental and critical task partners to understand data as a resource, and to cultivate the policies and from our CEO of vaccinating every person. capacity necessary for data to proliferate and improve outcomes for all. As I have been doing all I can to support our now fully-remote team, I’ve had This report highlights some of our achievements from 2019. We’ve once again First and foremost, we at Nexleaf hope you many opportunities to question and evolve my thinking on what leadership accomplished a remarkable amount, especially given the constraints we’ve and your families are safe and healthy. means now, and what it will mean for the future. For me, leadership has never all faced. As our world confronts multiple crises at once, we at Nexleaf are been about coming into a situation to “take charge,” but about initiating cultivating collaborations that result in concrete actions to address complex connections and creating space for collective learning and actions that result problems.
    [Show full text]
  • [email protected] • • • • Theory of Change: Supply Chain Factors Impacting Equity in Immunization Problem Strategies Outputs Long-Term Outcomes Impact
    [email protected] • • • • Theory of change: Supply chain factors impacting equity in immunization Problem Strategies Outputs Long-Term Outcomes Impact Health supply chains, including Supply chains are fit-for-purpose to immunization supply chains (iSC), provide accessible immunization were designed using a one-size- Identify supply chain barriers Supply chain barriers to ACCESS services with potent vaccines fits-all approach and have not available for all, especially under- that contribute immunization and health services are been responsive to the needs of immunized communities to zero-dose addressed under-served communities that Combined with are consistently under- kids and under- immunization ACCESS other immunized. Geographic clustering Immunization services are conveniently interventions: of zero-dose and under- and affordably accessed by all— Coverage Adapt supply immunized populations further Infrastructure strengthened and including zero-dose and under- increases in increases the probability of chains to be demand variation quantified to immunized communities – through under-served outbreaks of vaccine preventable more responsive improve AVAILABILITY public or private service delivery populations, to variations in diseases in already under-served AVAILABILITY especially zero- population dose and under- populations. Sufficient stock available and supply needs immunized chain responsive to demand variations populations Supply chain challenges of under- at public and private health facilities — immunized communities
    [Show full text]
  • Opportunities at the Last Mile 2018 ANNUAL IMPACT REPORT
    Opportunities at the Last Mile 2018 ANNUAL IMPACT REPORT Our Mission Save lives and improve health by increasing access to quality healthcare for the most underserved communities. Photo Credit: Paul Joseph Brown When I came to VillageReach in 2010, I joined a small global team of 15 people, based in Malawi, Mozambique and the United States, who shared a vision of improving health care delivery in rural From the communities. At that point, it was impossible for me to foresee where we would be eight years later — with a network of nearly 200 professionals working in 10 countries to replicate and scale the President work we started many years ago. VillageReach’s past success comes from the passion and tenacity of our staff and partners and the commitment from the Ministries of Health in the countries in which we work. I am proud of our accomplishments in 2018. In our three primary countries — Malawi, Mozambique and the Democratic Republic of Congo — we have surpassed many of our expectations. • In the Democratic Republic of Congo, I visited health centers in Équateur with the Honorable Health Minister Oly Ilunga Kalenga to observe supply chain improvements firsthand. Frequent stockouts of vaccines had prevented children from gaining immunity from diseases such as measles. An independent evaluation revealed there were no stockouts of vaccines in VillageReach-supported health zones in 2018. Just months after the visit, the Ministry of Health responded to an Ebola outbreak. To assist, VillageReach employed the last mile delivery system to an additional four affected health zones. • In Malawi, we celebrated the move of Chipatala cha pa Foni (CCPF), or “Health Center by Phone,” from its original home in Balaka to the Ministry of Health and Population’s Clinical Services unit in Lilongwe.
    [Show full text]
  • Prospects for Leveraging Private Sector Logistics Firms to Support Rural Access to Healthcare: Some Insights from Mozambique
    PROSPECTS FOR LEVERAGING PRIVATE SECTOR LOGISTICS FIRMS TO SUPPORT RURAL ACCESS TO HEALTHCARE: SOME INSIGHTS FROM MOZAMBIQUE J Beale, M Mashiri1 and J Chakwizira2 VillageReach Organisation, Seattle, United States of America, Cell: 1.206.755.0145 Email address: [email protected] 1GTRD, 25A Barnstable Road, Lynnwood Manor, Pretoria 0081, Email: [email protected] Cell: +27 72 122 9394 2University of Venda, School of Environmental Sciences, P/Bag X5050, Thohoyandou, 0950, South Africa; Tel: +27 (0)15 962 8585; Fax: +27(0)15 962 8587; Email: [email protected], [email protected] ABSTRACT For many rural communities across southern Africa, access to even the most basic healthcare is not guaranteed. Competing demands by public sector agencies for limited transport resources, plus poor vehicle maintenance standards, prevent public health system motor pools from being available consistently to reach health centers on a regular basis. The irregular availability and use of transport also results in higher overall costs of distribution of medical commodities due to vehicle breakdowns, higher rates of product wastage, and higher personnel costs per successful delivery. As a result, medical commodities including vaccines and essential medicines are not provided reliably or in sufficient supply, needlessly impacting the health of these communities. This paper reviews current transport practices within the Ministry of Health (MISAU) and highlights existing trends in commercial transport with a view to presenting considerations in which the two sectors could collaborate to achieve improved reliability and increased efficiency of the distribution of medical commodities. A mixed method approach was employed to gather, review and process information.
    [Show full text]
  • Annual Report 2016
    Annual Report 2016 Our Mission Save lives and improve health by increasing access to quality health care for the most underserved communities. VillageReach programs currently reach over Executive 16 million people across multiple countries Summary throughout sub-Saharan Africa. VillageReach’s commitment to partnership was a key driver of our work in 2016. Successful collaboration with governments, the private sector, and our global teams led to the continued scale up of sustainable health innovation, increasing access to health care in many communities throughout sub-Saharan Africa. Highlights from 2016 include: Next-Generation Supply Chains: Progress on next-generation supply chains entered a new phase with work beginning in the Democratic Republic of Congo. New approaches, such as the Transport Services Solution, explore how the private sector can contribute to public health supply chains. A new report, Lessons Learned in Reaching the Final 20, summarizes the evidence gathered from more than a decade of work improving immunization supply chains in Mozambique. Chipatala Cha Pa Foni (“Health Center by Phone”): A new partnership with Airtel in Malawi provides critical support for Chipatala Cha Pa Foni, leveraging the private sector to make this health hotline scalable and sustainable. This partnership is central to the growth of the hotline as VillageReach works with the Ministry of Health to reach national scale in 2017. In addition, CCPF for Adolescents was launched, strengthening the existing hotline service to provide youth-friendly sexual and reproductive health information and referrals to facility-based services. Pharmacy Assistant Training Program: The second cohort of pharmacy assistants graduated from Malawi’s Pharmacy Assistant Training Program, adding an additional 85 trained health workers who will improve medicines management and pharmaceutical practice in rural pharmacies throughout Malawi.
    [Show full text]
  • Years of Health Care, Delivered
    Years of Health Care, Delivered ANNUAL IMPACT REPORT 2020 Mission VillageReach transforms health care delivery to reach everyone. Photo Credit: Paul Joseph Brown IN 2020, VILLAGEREACH: This past year was filled with unprece- Mozambique expanded from three provinces dented change and heartbreaking loss. The to eight provinces, covering more than 75 COVID-19 pandemic exposed what so many percent of the country’s health facilities, know too well from personal experience— where it distributes essential medicines and Supported increased access to quality health care for although we were all in the same storm, how vaccines directly to health workers. we survived varied drastically across race, nationality and gender lines. This past year We did not let COVID-19 halt our progress. tested the health sector like never before. As you make your way through our annual Through it all, the VillageReach team stepped report, you’ll see several examples of how up and spent our twentieth year doing what VillageReach pivoted our focus to COVID-19 we do best: building systems that deliver. and continued essential services, building on what we know works in collaboration with 46 Million When the pandemic began, we saw a rise in government leaders and our partners. people in sub-Saharan Africa misinformation throughout communities in Malawi, Mozambique and the Democratic As the year drew to a close, we saw hope Republic of Congo. People were searching with the first COVID-19 vaccines arriving in for key steps they could take to protect the US and Europe, and we started counting MESSAGE FROM THE PRESIDENT MESSAGE themselves from the virus.
    [Show full text]
  • Closing the GAP in Openlmis Code
    ​ Achieving the vision of ‘shared investment, shared benefit’ community software development GAP Project Success Story OpenLMIS believes in an open source software development philosophy of ‘shared investment, and ​ shared benefit’ whereby our community of global users are linked through a core code base, and ​ enhancements made by one country can be accessed and used by anyone in the community. To achieve this vision, the United States Agency for International Development (USAID) and Digital Square funded the GAP Project, a 1 year initiative to unify the OpenLMIS codebase. Prior to the implementation of the GAP Project, the OpenLMIS community was comprised of a set of nation-wide implementations who were all using slightly different versions of OpenLMIS. Furthermore, the core code was often forked in different directions, and we lacked a plan or vision for community alignment on the various versions implemented. Because countries were using different versions of the software, their priorities, problems, and measures for success were different too. In this environment, community collaboration to improve OpenLMIS as an open source product became increasingly difficult as the user needs continued to diversify over time. OpenLMIS version 3.x is the current, community-supported version of OpenLMIS, which allows countries to share the same code base, and benefit from each others’ contributions and new features over time. The GAP project was introduced as a critical step in breaching the code gap for the national-level deployments of OpenLMIS v2. in Tanzania and Zambia, with the end goal of creating an upgrade path to OpenLMIS v3. Tanzania and Zambia were chosen as the representative v2 instances because of their long implementation history and continued active development by the local JSI team located in Zambia.
    [Show full text]
  • Med25: Funding Quality Health Care Through Social Enterprise
    Med25 Funding Quality Health Care through Social Enterprise VillageReach’s Med25 program helps communities develop income-generating businesses that support health care through their profits. This model effectively increases access to quality health care in remote and rural communities without long-term dependence on international aid. The Med25 name is derived from Article 25 of the Universal Declaration of Human Rights, which states everyone has a right to a standard of living adequate for their health and well-being. Med25 Case Study: Mbita How It Works A Community Transformed The Challenge: Mbita, Kenya is a rural community of The success of Med25 depends on the close collaboration of local communities, governments, 118,000 with limited economic opportunity. Access to other nonprofit organizations and the private quality health care is also inadequate. Existing health sector. VillageReach leads these partners through projects were forced to close as donor support ended, a proven approach, ensuring clear intensifying the critical shortage of health care in the communication and accountability among all community. stakeholders – from idea to impact. Through this process, we establish local, sustainable The Solution: The Med25 initiative was first launched in businesses that provide a social good and support Mbita through a comprehensive community-engagement health care services. process. It brought partner organizations and more than 400 community members together to identify needs and Identify community potential business models. Based on Med25’s in-depth with health need analysis, the community identified several viable income- generating businesses that also serve a vital social need. Conduct needs assessment Identify health service priorities and Investment partners provided funds for initial capital potential income-generating expenses.
    [Show full text]
  • Vidagás: Powering Health Clinics and Households in Mozambique with Liquefied Petroleum Gas
    Sub-Saharan Africa • Mozambique VidaGás: Powering Health Clinics and Households in Mozambique with Liquefied Petroleum Gas Prepared by • Courtenay Sprague (South Africa) Sector • Health & Energy Enterprise Class • Local SME Summary In a country with 500 doctors for a population of almost 20 million, initiatives that can expand the reach of health services to rural populations are in critical demand and short supply. The challenge for northern Mozambique’s health clinics is the lack of reliable fuel to provide lighting for surgery and routine operations and to guarantee regular refrigeration for the storage of vaccines. Besides, less than two percent of households have electricity, and are therefore dependent on wood or charcoal for cooking, which increases respiratory infections, pregnancy complications and forests degradation. Against this background, a wide range of partners gathered in 2002 to launch a pilot project in the province of Cabo Delgado in northern Mozambique, each one providing its own expertise: a former minister of education from Mozambique, Graça Machel, dedicated to children’s health; a Seattle-based NGO, VillageReach, dedicated to deliver needed health supplies to remote regions of Mozambique; Northern philanthropists willing to back the start-up; the Ministry of Health and the Governor of the pilot province, eager to provide state funding and eliminate state bureaucracy; and a community foundation, FDC (Fundação para o Desenvolvimento da Comunidade), aware of the complex development needs of Mozambicans. As a result of the partnership, VillageReach and FDC introduced an improved cold chain and replaced decrepit kerosene refrigerators in remote health facilities with Liquefied Petroleum Gas (LPG)-powered refrigerators.
    [Show full text]